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If you have mental health insurance you may assume that any provider that does not accept insurance is going to cost more, and in most cases you would be absolutely correct. However, our pricing is so low that you will likely save money by using our services “out of pocket” instead of utilizing a practice that accepts insurance. The entire cost of a visit with us could even be lower than just your insurance copay! Additionally, securing an appointment with insurance often takes several months whereas we can usually see someone within days. We also spend significantly more time with patients than insurance will typically cover, despite charging a lower rate. Insurance policies can vary drastically and comparing plans and reimbursement rates can become complicated very quickly. Therefore, to help you compare pricing, we put together the following guide to walk you through the process. Simply click on the following statement that most accurately applies to your situation:
If you have already satisfied your full yearly deductible: Our initial evaluation will usually cost more than using your insurance. However, a significant portion of that may be eligible for an “out of network” reimbursement claim. After the initial assessment, our pricing is so competitive that follow-up appointments are often less than using insurance, even after you have met your yearly deductible! To compare pricing, you would need to locate your “specialist” copay or coinsurance.
For those with a copay: Co-pays vary significantly, but a specialist copay has an approximate national average of $40. The typical public mental health clinic schedules medication management appointments for around 20 minutes (though it is not uncommon for the actual appointment to only last half that time). Therefore, with a $40 copay you are still paying about $2 per scheduled minute. Our total follow-up appointment pricing for a true 20 minutes is also available for $40 and with no risk of surprise billing if your deductible has not been met. Our patients start with 30 minute follow-ups because we believe they are a more appropriate length of time and these appointments start at $50. However, over time someone in remission may be eligible for shorter appointments at a rate as low as $35.
Other ways you may save:
If you are able to receive partial coverage with an out of network claim we are happy to provide treatment plans and “superbills” required by insurance companies, but we do not submit or complete these claims ourselves.
You will almost undoubtedly save money if you use our services out of pocket rather than using your insurance with another practice. The short version is: For follow-ups our pricing is less than half the cost you would pay with insurance when you still have a yearly deductible to meet! Even when our total price is higher than copay costs, we typically charge less than insurance companies reimburse practitioners who participate in their networks. If you have not yet met your deductible for the year and you use your insurance, you would be responsible for the remainder of this higher reimbursement amount (Note: We have already taken into consideration the typical “write-off” amounts. Providers set their own rates but then “write off” the difference between their rate and what they agreed to accept from the insurance company).
Every insurance company reimburses a different rate for services which may change throughout the year. Rates also vary by region and possibly other variables or factors the insurance company has chosen. Insurance companies prohibit their participating practitioners from publicizing their reimbursement rates, making comparisons difficult. However, we can utilize local rates made publicly available by Medicaid and Medicare to give us an approximate range. Private insurance companies typically fall in between these rates. The only accurate way to verify what your cost would be is to contact your insurance company and provide them with the following billing codes. Medication management billing is primarily based on acuity (severity) but in some cases can be based on amount of time spent with a patient when certain criteria are met. We are showing the time here to help simplify a complex system. If you use insurance, the practitioner will choose the code they feel is most appropriate and it may not align precisely with these time-frames.
You will almost undoubtedly save money by utilizing our services as our cash prices are extremely competitive. These charts provide a quick overview of approximate cash pricing for psychiatric services in the Baltimore area in 2019:
$50 or less*
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